This course presents a detailed discussion of allergic reactions and the development of bacterial resistance with regard to antibiotic use in treatment of adult periodontitis.

Upon completion of this course, participants should be able to do the following:

1. Identify the characteristics of a drug allergy reaction that distinguish it from other adverse reactions.
2. Discuss the different types of allergic reactions and the drugs commonly associated with them.
3. Describe the sensitization potential of topical tetracycline.
4. Discuss the development of bacterial resistance and the factors that are believed to minimize it.

The high incidence of allergic reactions to some common dental antibiotics, primarily topical penicillin, has led to general concerns about all topical antibiotics. Delivery technologies providing for site-specific drug delivery have renewed interest in the use of topical antimicrobials to treat adult periodontitis. Despite tetracycline's widespread dermatologic use and increasing use in adjunctive treatment of adult periodontitis, the incidence of allergic response to topical tetracycline is very low. Studies with tetracycline fiber showed no significant change in the tetracycline susceptibility of gram-negative periodontal microorganisms. Our discussion of this important topic may help practicing dentists and periodontists distinguish between the allergic potential of sensitizing antibiotics, such as the penicillin, and that of low sensitizers such as tetracycline. In addition, this article briefly discusses bacterial resistance to increase understanding about the relative potential for tetracycline resistance with differing treatment regimens.

1. Introduction
   
   
2. Allergic Responses and Other Adverse Drug Reactions
   
   
   1. Allergic Response Types and Common Sensitizers
      
      
      1. Type I - Anaphylactic
         
         
      2. Type II - Cytolytic
         
         
      3. Type III - Arthus
         
         
      4. Type IV - Delayed Hypersensitivity
         
      
      
   2. Topical Tetracycline and Allergic Response
      
      
      1. Dermatologic Use
         
         
      2. Periodontal Use
         
   
   
3. Bacterial Resistance
   
   
4. Summary

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